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Sunday, September 26, 2010
Title: Domestic Abuse Screening: Defining the Problem to Create the Solution
Discipline: Women’s Health (WH), Professional Issues (PI), Childbearing (CB)
Learning Objectives:
Submission Description:- Describe the importance adequate domestic abuse training for bedside nurses charged with abuse screening.
- Discuss how a Likert scale can be used to define a perceived problem.
- Describe the elements of domestic abuse information useful to Maternal/Child bedside nurses.
Domestic abuse is a reality for many women. Statistics show that thirty-one percent of women report physical or sexual assault by an intimate partner during their lifetime (Family Violence Prevention Fund, 2008). These numbers may not reflect the actual incidences of violence due to difficulty in tracking cases of domestic abuse. Inconsistent definitions of abuse for tracking, lack of a national tracking system and underreported incidents by victims who often fear retribution or are ashamed of their situation contribute to inaccurate statistics (DuPlat-Jones, 2006).
Domestic abuse impacts the healthcare system in multiple ways. Increased use of the health care system by both victims and witnesses of abuse has been documented in many studies. Children exposed to physical violence in the home are more likely to develop physical health problems such as bed-wetting, headaches and gastrointestinal problems, as well as behavioral health problems, such as depression and violent acting-out (Family Violence Prevention Fund, 2008). Children in homes where domestic violence occurs are 50% more likely to be abused themselves. Women who are domestic abuse victims are more likely to engage in negative health behaviors (DuPlat-Jones, 2006). Yam (2000) lists the long-term health problems of women victims including permanent physical disability, pre-natal complications, depression, anxiety, and substance abuse. The health-related costs of domestic abuse to society, estimated at $4.1 billion, underline the importance of addressing domestic abuse itself in order to stem its widespread effects (Brackley, 2008).
To improve care to women who encounter the Maternal/Child department of a hospital that performs 7,000 deliveries a year, an education project addressing domestic abuse screening and nursing response to victims was developed. A Likert-scale survey initiated the project. Designed to assess nurses’ attitudes towards domestic abuse screening, the study showed that time to perform the screening, rating the screening as important as other nursing assessments, and fear of offending the patient were not barriers to screening. Results revealed that nurses felt they were able to identify victims but lacked confidence in performing an in depth assessment and in the victim actually finding help. Being able to respond to a victim who admitted to abuse obtained only a slightly favorable rating with nearly equal positive and negative responses. Previous training in domestic abuse was rated inadequate. This research proved that education could be part of the solution to improving the identification and referrals of domestic abuse victims.
Based on these results, an educational packet was designed which purposely addressed these needs. While information presented was obtained from hospital policies and care plan guidelines was particular to the hospital system, the integration of current, evidence-based information on domestic abuse helped present useful approaches for bedside nurses in the hospital setting. Sharing the current science of domestic abuse research was a major goal. Specific local resources were described and contact information provided. The completed packet earned the nurse continuing education credits. A pre- and post-test is being utilized to evaluate results, but thus far, favorable comments foreshadow a positive outcome.
Domestic abuse impacts the healthcare system in multiple ways. Increased use of the health care system by both victims and witnesses of abuse has been documented in many studies. Children exposed to physical violence in the home are more likely to develop physical health problems such as bed-wetting, headaches and gastrointestinal problems, as well as behavioral health problems, such as depression and violent acting-out (Family Violence Prevention Fund, 2008). Children in homes where domestic violence occurs are 50% more likely to be abused themselves. Women who are domestic abuse victims are more likely to engage in negative health behaviors (DuPlat-Jones, 2006). Yam (2000) lists the long-term health problems of women victims including permanent physical disability, pre-natal complications, depression, anxiety, and substance abuse. The health-related costs of domestic abuse to society, estimated at $4.1 billion, underline the importance of addressing domestic abuse itself in order to stem its widespread effects (Brackley, 2008).
To improve care to women who encounter the Maternal/Child department of a hospital that performs 7,000 deliveries a year, an education project addressing domestic abuse screening and nursing response to victims was developed. A Likert-scale survey initiated the project. Designed to assess nurses’ attitudes towards domestic abuse screening, the study showed that time to perform the screening, rating the screening as important as other nursing assessments, and fear of offending the patient were not barriers to screening. Results revealed that nurses felt they were able to identify victims but lacked confidence in performing an in depth assessment and in the victim actually finding help. Being able to respond to a victim who admitted to abuse obtained only a slightly favorable rating with nearly equal positive and negative responses. Previous training in domestic abuse was rated inadequate. This research proved that education could be part of the solution to improving the identification and referrals of domestic abuse victims.
Based on these results, an educational packet was designed which purposely addressed these needs. While information presented was obtained from hospital policies and care plan guidelines was particular to the hospital system, the integration of current, evidence-based information on domestic abuse helped present useful approaches for bedside nurses in the hospital setting. Sharing the current science of domestic abuse research was a major goal. Specific local resources were described and contact information provided. The completed packet earned the nurse continuing education credits. A pre- and post-test is being utilized to evaluate results, but thus far, favorable comments foreshadow a positive outcome.
